Updated Special Pays Frequently Asked Questions – 3 MAR Edition
As you can imagine, we’ve been getting a lot of questions in the Corps Chief’s Office about the FY20 pay plan. We’ve compiled a list of the questions so far and answers. Here they are with new ones noted in bold:
Q – For newly board certified physicians, what is the difference between a board certification pay (BCP) request and a retroactive BCP request? For example, you passed your board on 1 Jan 2020, but were waiting to put the request in for BCP until the FY20 NAVADMIN was released and you lack the letter from your board confirming that you have passed the boards (which will come later in the spring). Must you wait to request BCP until the physical letter arrives, or is there other proof of board certification (e.g. screen shot, web print out) that one can provide as substantiating documentation?
A – A retroactive BCP request is simply a request for BCP that begins at a date that has already passed. In order to receive BCP, you must provide proof of your board certification date, which is not necessarily the day you took your board exam. You can do this one of two ways: (1) provide a copy of the official notification from your ABMS board that you are board certified as of whatever date, or (2) ask your local credentials office to verify your board certification status for you and then submit the primary source verification (PSV) as proof of board certification through your local special pays coordinator.
Q – If an AD member in a specialty for which pays were reduced (OB/GYN, Peds, etc.) wanted to transfer GI Bill benefits to a child, which incurs a new service obligation, would that member would no longer be eligible to take a retention bonus for the four year obligation associated with the GI Bill transfer?
A – Obligation associated with non-medical training (e.g. GI Bill, War College) does not disqualify you from accepting an RB. To put it another way, you can transfer your GI Bill to your child and still have your RB.
Q – If you are eligible for your continuation pay (8-12 years’ time in service) and you accept it, does that mean you can’t get a retention bonus if you are in those specialties that are not eligible for RB with any active duty service obligation?
A – No. Continuation pay is unrelated to RB eligibility. You can have continuation pay and your RB at the same time.
Q – Can I just resign/retire and/or ask for a waiver if I have an existing obligation, time in grade requirements, or time left on my current RB?
A – You are entitled to submit a request to resign or retire and/or submit a waiver request for any remaining service obligation, time in grade, etc. in order to facilitate resignation/retirement. Requests are routed through PERS. If granted (and that is a big if), however, the Navy may elect to recoup any extra special or incentive pays you have already received (e.g. the difference in the 4 year and 2 year RB amounts). Please see this page on waivers or this page on resignations for more information.
Q – The Special Pays instruction states in paragraph 2.a.(1) “Is serving in the Medical specialty for which the IP is being paid” and in 2.a.(3) “Member must continue to be credentialed, privileged, and practicing at a facility designated by the Surgeon General as an authorized medical facility, in the Medical specialty for which the IP is being paid”. For RB, it states under paragraph 3.a. “To be eligible for the AD RB, a Physician.meets the same eligibility requirements as for the active duty IP” and in 3.a.(5) is “practicing at a facility designated by the Navy as an authorized facility, in the Medical Specialty for which the RB is being paid, and maintain those for the length of the agreement”. According to Table 2, there is a clear distinction made between General Internal Medicine (IM) and the CAT IV Subspecialties. If I execute an IP/RB for a CAT IV Subspecialty, would I only practice in my Subspecialty and not be required to practice General IM?
A – No. The Navy requires you to maintain General IM privileges regardless of subspecialty, so you must continue to do that. That said, you can only be paid an RB based on one specialty, even if you have privileges in multiple specialties. Since IM subspecialties are paid at a higher rate than General IM, you are better served collecting your IP/RB based on your CAT IV subspecialty.
Q – If I am on a 4-year retention bonus but that option no longer exists for my specialty, can they take it away?
A – No, per the guidance on the BUMED Special Pays website, “If a member is under an existing agreement, the officer will continue to be paid the rate in that agreement until it expires.”
Q – If you are in OB/GYN, Ophthalmology, Otolaryngology, Urology, Pathology, Family Medicine, General Internal Medicine, Pediatrics, Nuclear Medicine, or Radiology, it appears you can no longer take a Retention Bonus (RB) if you have any obligated service when previously it was only your initial obligation that had to be repaid before you could take an RB. Is that correct?
A – Yes, that is correct. Paragraph 3.a.(6) on page 5 of the Medical Corps Special Pays guidance states that physicians in these specialties “are not eligible to enter an RB while under an Active Duty Service Obligation (ADSO) for medical education, training, or Special Pays RB.” You cannot have any obligated service if you wish to sign up for an RB in these specialties during FY20.
Q – For the specialties that saw loss of the 4 year RB and/or reductions in IP/RB amounts, will time-in-grade (TIG) or service obligation (MSR) waivers be offered?
A – At present, no. However, a draft NAVADMIN that addresses TIG and MSR waivers that is with PERS; it was placed on hold due to Congressional language which prohibits the military divestitures until a Report to Congress is submitted. No timeline for a decision is available.
Q – The DFAS medical special pay website has different values/contracts available for FY-2020. Are the major changes announced yesterday specific to the Navy and the Army/Air Force special pays for 2020 are reflected on this website?
A – The rates posted on the DFAS website are the maximum allowable payment rates set by DOD. Physician pay plans are service-specific, and the services are allowed to pay “up to” those amounts. The pay rates in the documents we sent yesterday (27 FEB) and that are available on the BUMED Special Pays Website are the relevant rates for the Navy in FY20.
Q – If I have a valid RB, is there anything I need to do?
A – No. There is no longer a need to submit an annual request. Your IP and RB will continue to pay at the current rate through the expiration of your contract.
Q – Why is Family Medicine one of the specialties affected by the reductions when it’s not currently overmanned?
A – The special pays plan was based on manning levels that incorporated some of the planned divestitures. Yes, I know this seems to run counter to the NAVADMIN argument above.
Q – Does terminate and renegotiate extend the time owed?
A – Yes. If you terminate and renegotiate, your obligation resets to day 0 on the effective date of the contract. For example, if you currently have three years left on a 4 year contract (obligated until 2023) and you terminate and renegotiate for a 6 year RB, you would then be obligated through 2026.
Q – Are the RB and GME reductions temporary, or will they continue until some specialties are eliminated from Navy Medicine?
A – First, there are NO PLANS TO ELIMINATE ANY SPECIALTY(IES). Special pays are reviewed yearly and are set based on current inventory compared to future requirements. In the black and white world of the Comptroller, overmanned communities do not merit or require retention incentives; the fact that we can continue to offer something was a concession on their part. However, although our office has strenuously advocated against this approach (as has much of BUMED) over the last 18 months, “voluntary” force shaping measures such as reduction of special and incentive pays are likely to persist until inventory matches requirements.
Special Pays Frequently Asked Questions
As you can imagine, we’ve been getting a lot of questions in the Corps Chief’s Office about the FY20 pay plan. We’ve compiled a list of the questions so far and answers. Here they are…
Q – If I am on a 4-year retention bonus but that option no longer exists for my specialty, can they take it away?
A – No, per the guidance on the BUMED Special Pays website, “If a member is under an existing agreement, the officer will continue to be paid the rate in that agreement until it expires.”
Q – If you are in OB/GYN, Ophthalmology, Otolaryngology, Urology, Pathology, Family Medicine, General Internal Medicine, Pediatrics, Nuclear Medicine, or Radiology, it appears you can no longer take a Retention Bonus (RB) if you have any obligated service when previously it was only your initial obligation that had to be repaid before you could take an RB. Is that correct?
A – Yes, that is correct. Paragraph 3.a.(6) on page 5 of the Medical Corps Special Pays guidance states that physicians in these specialties “are not eligible to enter an RB while under an Active Duty Service Obligation (ADSO) for medical education, training, or Special Pays RB.” You cannot have any obligated service if you wish to sign up for an RB in these specialties during FY20.
Q – For the specialties that saw loss of the 4 year RB and/or reductions in IP/RB amounts, will time-in-grade (TIG) or service obligation (MSR) waivers be offered?
A – At present, no. However, a draft NAVADMIN that addresses TIG and MSR waivers that is with PERS; it was placed on hold due to Congressional language which prohibits the military divestitures until a Report to Congress is submitted. No timeline for a decision is available.
Q – The DFAS medical special pay website has different values/contracts available for FY-2020. Are the major changes announced yesterday specific to the Navy and the Army/Air Force special pays for 2020 are reflected on this website?
A – The rates posted on the DFAS website are the maximum allowable payment rates set by DOD. Physician pay plans are service-specific, and the services are allowed to pay “up to” those amounts. The pay rates in the documents we sent yesterday (27 FEB) and that are available on the BUMED Special Pays Website are the relevant rates for the Navy in FY20.
Q – If I have a valid RB, is there anything I need to do?
A – No. There is no longer a need to submit an annual request. Your IP and RB will continue to pay at the current rate through the expiration of your contract.
Q – Why is Family Medicine one of the specialties affected by the reductions when it’s not currently overmanned?
A – The special pays plan was based on manning levels that incorporated some of the planned divestitures. Yes, I know this seems to run counter to the NAVADMIN argument above.
Q – Does terminate and renegotiate extend the time owed?
A – Yes. If you terminate and renegotiate, your obligation resets to day 0 on the effective date of the contract. For example, if you currently have three years left on a 4 year contract (obligated until 2023) and you terminate and renegotiate for a 6 year RB, you would then be obligated through 2026.
Q – Are the RB and GME reductions temporary, or will they continue until some specialties are eliminated from Navy Medicine?
A – First, there are NO PLANS TO ELIMINATE ANY SPECIALTY(IES). Special pays are reviewed yearly and are set based on current inventory compared to future requirements. In the black and white world of the Comptroller, overmanned communities do not merit or require retention incentives; the fact that we can continue to offer something was a concession on their part. However, although our office has strenuously advocated against this approach (as has much of BUMED) over the last 18 months, “voluntary” force shaping measures such as reduction of special and incentive pays are likely to persist until inventory matches requirements.
DHA Director Discusses Vision for Future
Here’s a link to this article:
Finance Friday Articles
Most importantly:
Here are my favorites this week:
Don’t Tinker With Your Portfolio
Four Critical Questions for Index Fund Investors
Stand Your Ground in the Face of Coronavirus Induced Market Volatility
Here are the rest of this week’s articles:
3 Major Myths About Financial Freedom
5 Companies Make up 18% of the S&P 500. Should Investors Care?
7 Contract Topics Every Physician Needs to Review
12 Things That Won’t Help You During a Market Correction
A Successful Real Estate Crowdfunding Investment: Key Lessons Learned
Coronavirus, uncertainty, and the markets
Lazy Workers are Bad; Lazy Portfolios Are Great
Medical Device Patent: A Quick Path to Financial Independence?
Physicians Were Targeted, Allegedly Scammed out of Tens of Millions of Dollars
Should You Pay Off Your Mortgage Early With Rates So Low?
Renovations! All at Once or Piece by Piece?
Six Ways You Can Increase Your Risk Tolerance
The Young Person’s Guide to Investing (requires a NY Times login)
What early retirement means when you’re too young to retire
What Happens When You Buy the Dip?
Why An Adjustable-Rate Mortgage Is Better Than A 30-Year Fixed-Rate Mortgage
FY20 Special Pays Plan Released
The FY20 pay plan NAVADMIN was released today. Here are the documents and below them is the message I sent to the Medical Corps today about the plan and changes:
- FY20 MEDICAL DEPT SPECIAL PAYS ADMIN INFO
- FY20 DENTAL CORPS AC SPECIAL PAYS GUIDANCE
- FY20 MEDICAL CORPS AC SPECIAL PAYS GUIDANCE
- FY20 MEDICAL SERVICE CORPS AC SPECIAL PAYS GUIDANCE
- FY20 NURSE CORPS AC SPECIAL PAYS GUIDANCE
The most common question I’ve received so far is what happens if you are already on a Retention Bonus (RB) and that option is removed for your specialty? For example, you are on a 4-year RB and they removed that option. In that case, you just continue on that RB agreement. There is no change, your pay doesn’t drop, and you don’t get kicked off of it.
ALCON,
The FY20 Medical Department Special Pays Plan has been released, is attached, and is available on the BUMED Special Pays Website. As a result, we’d like to provide some additional information and background.
As the National Defense Strategy (NDS) reminds us, “We have a responsibility to gain full value from every taxpayer dollar spent on defense, thereby earning the trust of Congress and the American people.” In this spirit, the Department of Defense is pursuing aggressive reforms to ensure resources are being put toward the highest priority activities. In doing so, we must be willing to make tough choices as we engage in the great power competition and execute the NDS.
As a result, Navy Medicine developed plans to align Fiscal Year (FY) 2020 special pays guidance with warfighter requirements and decided to reduce or eliminate some special and incentive pays for select medical specialties. This decision was not taken lightly, and was made within the greater context of supporting operational requirements, while balancing force structure and in a fiscally constrained environment. Special and incentive pay reductions were limited to what was absolutely necessary based on operational requirements. Major changes include:
- Increased Incentive Pay with 4-year and 6-year Retention Bonus contracts for certain specialties to include anesthesiology, general surgery, neurosurgery, orthopedics, and subspecialty category I.
- Limits ability to terminate early and renegotiate contracts for certain specialties to include: obstetrician/gynecology, ophthalmology, otolaryngology, urology, pathology, family medicine, general internal medicine, pediatrics, nuclear medicine, radiology, and radiation oncology.
- Eliminates 6-year Retention Bonus for family medicine.
- Eliminates 4-year Retention Bonus for certain specialties to include: obstetrician/gynecology, ophthalmology, otolaryngology, urology, pathology, family medicine, general internal medicine, pediatrics, nuclear medicine, radiology, and radiation oncology.
- Reduces Retention Bonus dollar amounts by $2,000 per year for certain specialties to include: obstetrics/gynecology, ophthalmology, otolaryngology, urology, family medicine, and general internal medicine.
- Reduces Retention bonus dollar amounts by $3,000 per year for certain specialties to include: pathology, pediatrics, radiology, and radiation oncology.
There are other changes not listed above, and the special pay changes are not at all related to the transition to DHA.
To the entire Medical Corps, we would like to emphasize that we will reassess special and incentive pay each year to determine if any changes need to be made to manage operational requirements. This is only a one year pay plan, and we will continue to advocate on your behalf to the best of our ability in future years. Some specialties are growing in both size and amounts of special pay offered. In addition, Navy Medicine continues to offer exciting opportunities to physicians that are generally unavailable in the private sector like flight training, Special Operations experience, undersea medicine, and others. Doing these unique things is why many of us joined the Navy.
To current medical students, interns, general medical officers, flight surgeons, and undersea medical officers, we’d like to emphasize that there will still be Graduate Medical Education opportunities available for all specialties. Some specialties are growing as Navy Medicine aligns to better support readiness and the warfighter.
As was sent out in yesterday’s notice, Specialty Leaders and individual officers should not contact the BUMED Special Pay office directly. The Special Pay Office will have an increased workload over the next several months with processing the requests received. Here is who everyone should communicate with:
- Individual members should work through their Special Pay Coordinators with questions. Should the Coordinators have questions, they are the liaison to the BUMED Special Pays office.
- Specialty Leaders should reach out to CDR Melissa Austin in my office with questions, and I will serve as an alternate POC. For questions we can’t answer, we will work to get you the answers ASAP.
Thank you for everything you do every day for the Medical Corps.
V/R,
Joel M. Schofer, MD, MBA, CPE, FAAEM, FAAPL
Throwback Thursday Classic Post – My Guest Post on White Coat Investor – Disability Insurance for Military Physicians
Figured this is a good repeat due to the update we posted on Monday about disability insurance. Check out my guest post on the White Coat Investor site:
29 Palms Director of Medical Services Position – O4/O5/O6
If you are a O4 or above, the 29 Palms Director of Medical Services (DMS) position is rolling this summer. As always, you either need to already be there, have orders there, or an e-mail from your Detailer saying you can apply. The deadline is 1 APR and the details are in this document:
VADM(r) Bono Discusses Concerns About Transferring Medical Facilities to the DHA
Here’s a link to this 6 minute video:
VADM(r) Bono Discusses Concerns About Transferring Medical Facilities to the DHA
Here’s a transcript:
Date: February 18, 2020
Title: VADM (Ret.) Raquel Bono on Government Matters
Source: Government Matters
Francis Rose: The Secretary of the Army Ryan McCarthy wants to put a hold on
transferring the Army’s medical treatment facilities to the Defense Health
Agency, at least for now. He says he’s concerned about a lack of performance
and planning. Vice Admiral Raquel Bono, U.S. Navy retired, former Director
of the Defense Health Agency, Rocky, welcome back, it’s great to have you.
VADM Bono: Thank you.
Rose: What do you see when you look at the reports about Secretary McCarthy,
his concerns about the DHA, based on your experience from inside the
organization?
Bono: I think the most important thing Francis, is the people are continuing
to work together towards the end goal. It’s very clear where Congress wants
us to go and the work that the Defense Health Agency — with the Services
— has already put in place quite a few changes.
Rose: What are the changes that are happening? What are the changes that
it’s your takeaway that Secretary McCarthy wants that he hasn’t seen yet?
Bono: Yes, so I believe that as I was leaving, we had already transferred
some of the MTFs to the Defense Health Agency, and with the beginning of
this new calendar year there were going to be some new military treatment
facilities that were going to be rolling over. And so, I believe that in
that, we already had an established set of metrics that we wanted to use to
monitor the progress. I think it’s wise to be able to stop and assess those
metrics and make sure that the progress that we wanted to achieve is
actually occurring.
Rose: A Federal News Network reports say that Secretary McCarthy wants to
halt the transition until a detailed budget strategy and plan to transfer
functions from the Services is delivered. What has to happen – I know you’re
not inside the Agency now, but based on your knowledge how far along is that
effort and what does that look like? Does that answer the concerns do you
think that Secretary McCarthy and other military leaders maybe in the other
branches might have if how this shift of MTFs is happening?
Bono: Well, I think the nice thing about it before I left, is that we had
the conversations with the Services to understand how best to undertake a
transfer of function that would include not only the capabilities, but the
personnel involved. So, I believe that that conversation has already been
put in place, those plans have already been laid out, and what is probably
of merit is going over and perhaps doing a rehearsal of capability, and
being able to show how that actually plays out.
Rose: What did you find were the major differences among the branches and
the way they provided care to their members?
Bono: There are always differences in delivery, also differences in how
appointments are made, and so what the overall goal for the Defense Health
Agency was to make the experience of care for our patients similar, no
matter where they went to get their care.
Rose: That strikes me as kind of back office stuff, that’s not the way, the
type of care that maybe an airman needs to receive compared to the way that
the type of care that a soldier needs to receive. I imagine there are some
differences, but not major differences… maybe I don’t know what I’m talking
about, I’m not a medical professional, but you are. Are there major
differences between what a cohort of airmen need, versus a cohort of
sailors, versus a cohort of Marines, versus a cohort of soldiers?
Bono: Well, there’s always going to be unique nuances, depending on the
Service, but you’re right, most of the care that we give is primary care,
preventive care and when needed, specialty care, and all of that is pretty
similar.
Rose: What do you think are the major milestones that we should watch coming
out of DHA, not necessarily just pertinent to the concerns that the Army
has, but also more broadly?
Bono: You’ll continue to see more of the MTFs coming under the Defense
Health Agency. You’ll also probably see identification of markets where
there are collections of military treatment facilities in certain geographic
areas that will also start migrating to the Defense Health Agency, and in
the backdrop of that you’ll also see coordination and parallel movement with
the deployment of the electronic health record, MHS GENESIS, and then you’ll
also see refinement of the TRICARE health plan.
Rose: When you mentioned the movement of places where there are a number of
facilities, everybody hates the word consolidation, but it strikes me, the
quantity of care that DHA provides will have to equal the quantity of care
that’s provided, so consolidation isn’t necessarily a dirty word in this
case, is it?
Bono: No, as a matter of fact, that’s where a lot of the efficiencies will
be realized, by consolidating as you mentioned previously, those back-office
functions.
Rose: The back-office function consolidation, what does that look like? How
is that continuing and what are the gains that the person who is seeking
care from DHA will see? Will it make a difference to that person?
Bono: It shouldn’t make an obvious difference. Where they will probably
experience a difference, and this is actually the goal, is in their
experience of care. So how they make an appointment on the east coast should
be the same as they make an appointment on the west coast.
Rose: GENESIS is the backbone of that, right?
Bono: GENESIS has a very large role to play in that, exactly.
Rose: What are the markers we should watch for on GENESIS moving forward?
Bono: GENESIS is actually moving really nicely now. And now that we
understand what some of our challenges are in the infrastructure area and
what we needed to do, the Defense Health Agency is continuing that, and then
as the migration of medical devices and user devices to that new network, as
well as the adoption of workflows.
Rose: Was the big game changer for the GENESIS rollout the shift in the way
that you trained providers how to use it?
Bono: That had a big, big impact on that.
Rose: The big change there from, I believe that last time we talked before
you retired was that you were training people before how to use software and
you kind of shifted that mindset to get them to understand this is just a
facilitator to provide the care, here’s how you provide care in the context
of this new thing, is that a fair statement?
Bono: Yes, absolutely.
Rose: Admiral Bono thanks very much for coming on, it’s great to have you
back.
Bono: My pleasure thank you.
Guest Post from DI4MDs – An Update on Disability Insurance for Military Physicians and Dentists
(Note: I receive no compensation if you use DI4MDs for your insurance needs. I continue to lose $99 per year on this blog.)
Disability insurance which protects military physicians and dentist’s greatest asset continues to be a very limited market with few insurance companies and agents providing this critical protection. The available plan options depend on which stage of your medical/dental career you are in.
For military physicians and dentists at any stage of their medical career, MassMutual will provide the recommended specialty specific / own occupation disability coverage. MassMutual continues to be the only company that offers a non-cancelable and guaranteed renewable policy to age 65 and is the first policy we recommend. This policy is now available in all states.
For military physicians and dentists who have completed training, Lloyd’s is also available and can work well as a supplement to MassMutual coverage or if there is a medical issue. However, the policy does not contain the same premium and renewability guarantees as MassMutual’s policy.
If you are a resident or fellow and are at least 60 days away from graduating, in addition to MassMutual another option is a policy with Ameritas. However, you should be aware that Ameritas does not cover disabilities resulting from military service when scheduled active duty is more than 3 months. You do have the option of suspending the policy. Suspending the policy locks in your current insurability but does not provide any coverage during the suspension (though no premiums would be due either).
If you are in medical school and more than 180 days away from starting a military residency, in addition to MassMutual and Ameritas you will be able to apply for a policy with Standard. However, Standard will not cover disabilities resulting from military training, action, or conflict. Like Ameritas, you have the option of suspending the policy. Principal and Guardian may also be available if you are still in medical school. However, unlike the voluntary suspension option with Ameritas and Standard, Principal and Guardian require that your policy be suspended once you enter active duty. All medical students can obtain disability coverage without income qualification.
One crucial fact to be aware of when obtaining disability coverage is the medical underwriting requirement. Since military medical exams are extremely thorough and document any medical condition it is important to establish coverage early in your medical career before any conditions or ailments appear. Depending on the medical condition you may be declined coverage, issued a policy with a waiver/exclusion for the pre-existing condition(s) or issued with an increased premium. Even a combination of the latter two is possible. This can be avoided if you apply now so you can have the protection you need later. A policy with an option that will allow you to purchase additional coverage in the future regardless of health can be established to fit any budget. A graded premium structure can also be used to reduce the initial premium outlay for residents and medical students.
There is no better time than now to establish the type of policy you need to protect your medical or dental career in the event of disability. Please contact us below to begin:
DI4MDS – Andy Borgia, CLU and D.K. Unger – www.DI4MDS.com
10505 Sorrento Valley Rd., #250
San Diego, CA 92121
888-934-4637
858-523-7511 or 858-523-7529 after 5pm PT
Joel Schofer's Career Planning Blog 